Aliza Mushtaq, Ismaheel O Lawal, Saima Muzahir, Sarah C Friend, Manali Bhave, Jane L Meisel, Mylin A Torres, Toncred M Styblo, Cathy L Graham, Kevin Kalinsky, Jeffrey Switchenko, Gary Allan Ulaner, David M Schuster
{"title":"针对转移性小叶乳腺癌的氨基酸转运和 PSMA 靶向正电子发射断层扫描的前瞻性研究。","authors":"Aliza Mushtaq, Ismaheel O Lawal, Saima Muzahir, Sarah C Friend, Manali Bhave, Jane L Meisel, Mylin A Torres, Toncred M Styblo, Cathy L Graham, Kevin Kalinsky, Jeffrey Switchenko, Gary Allan Ulaner, David M Schuster","doi":"10.1007/s00259-024-06830-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To explore the feasibility of imaging amino-acid transport and PSMA molecular pathways in the detection of metastatic breast invasive lobular carcinoma (ILC) and if there is superior detection compared to standard-of-care imaging [computed tomography (CT)/bone scan, or <sup>18</sup>F-FDG positron-emission-tomography (PET)-CT].</p><p><strong>Methods: </strong>20 women with de-novo or suspected metastatic ILC underwent two PET-CT scans with <sup>18</sup>F-fluciclovine and <sup>68</sup>Ga-PSMA-11 on separate days. Uptake per patient and in 3 regions per patient - ipsilateral axillary lymph node (LN), extra-axillary LN (ipsilateral supraclavicular or internal mammary), or distant sites of disease - was compared to standard-of-care imaging (CT/bone scan in 13 patients and <sup>18</sup>F-FDG PET-CT in 7 patients). Results were correlated to a composite standard of truth. Confirmed detection rate (cDR) was compared using McNemar's test. Mean SUVmax of <sup>18</sup>F-fluciclovine and <sup>68</sup>Ga-PSMA-11 in the most avid lesion for each true positive metastatic region and intact primary lesion were compared by t-test.</p><p><strong>Results: </strong>The cDR for standard-of-care imaging was 5/20 patients in 5/60 regions. <sup>68</sup>Ga-PSMA-11 PET-CT detected metastasis in 7/20 patients in 7/60 regions. <sup>18</sup>F-fluciclovine PET-CT detected metastasis in 9/20 patients in 12/60 regions. The cDR for <sup>18</sup>F-fluciclovine PET-CT was significantly higher versus standard-of-care imaging on the patient and combined region levels, while there were no significant differences between <sup>68</sup>Ga-PSMA-11 and standard-of care imaging. <sup>18</sup>F-fluciclovine cDR was also significantly higher than <sup>68</sup>Ga-PSMA-11 on the combined region level. Mean SUVmax for true positive metastatic and primary lesions with <sup>18</sup>F-fluciclovine (n = 18) was significantly greater than for <sup>68</sup>Ga-PSMA-11 (n = 11) [5.5 ± 1.8 versus 3.5 ± 2.7 respectively, p = 0.021].</p><p><strong>Conclusion: </strong>In this exploratory trial, <sup>18</sup>F-fluciclovine PET-CT has a significantly higher cDR for ILC metastases compared to standard-of-care imaging and to <sup>68</sup>Ga-PSMA-11. Mean SUVmax for true positive malignancy was significantly higher with <sup>18</sup>F-fluciclovine than for <sup>68</sup>Ga-PSMA-11. Exploratory data from this trial suggests that molecular imaging of amino acid metabolism in patients with ILC deserves further study.</p><p><strong>Clinical trial registration: </strong>Early phase (I-II) clinical trial (NCT04750473) funded by the National Institutes of Health (R21CA256280).</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":null,"pages":null},"PeriodicalIF":8.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prospective investigation of amino acid transport and PSMA-targeted positron emission tomography for metastatic lobular breast carcinoma.\",\"authors\":\"Aliza Mushtaq, Ismaheel O Lawal, Saima Muzahir, Sarah C Friend, Manali Bhave, Jane L Meisel, Mylin A Torres, Toncred M Styblo, Cathy L Graham, Kevin Kalinsky, Jeffrey Switchenko, Gary Allan Ulaner, David M Schuster\",\"doi\":\"10.1007/s00259-024-06830-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To explore the feasibility of imaging amino-acid transport and PSMA molecular pathways in the detection of metastatic breast invasive lobular carcinoma (ILC) and if there is superior detection compared to standard-of-care imaging [computed tomography (CT)/bone scan, or <sup>18</sup>F-FDG positron-emission-tomography (PET)-CT].</p><p><strong>Methods: </strong>20 women with de-novo or suspected metastatic ILC underwent two PET-CT scans with <sup>18</sup>F-fluciclovine and <sup>68</sup>Ga-PSMA-11 on separate days. Uptake per patient and in 3 regions per patient - ipsilateral axillary lymph node (LN), extra-axillary LN (ipsilateral supraclavicular or internal mammary), or distant sites of disease - was compared to standard-of-care imaging (CT/bone scan in 13 patients and <sup>18</sup>F-FDG PET-CT in 7 patients). Results were correlated to a composite standard of truth. Confirmed detection rate (cDR) was compared using McNemar's test. Mean SUVmax of <sup>18</sup>F-fluciclovine and <sup>68</sup>Ga-PSMA-11 in the most avid lesion for each true positive metastatic region and intact primary lesion were compared by t-test.</p><p><strong>Results: </strong>The cDR for standard-of-care imaging was 5/20 patients in 5/60 regions. <sup>68</sup>Ga-PSMA-11 PET-CT detected metastasis in 7/20 patients in 7/60 regions. <sup>18</sup>F-fluciclovine PET-CT detected metastasis in 9/20 patients in 12/60 regions. The cDR for <sup>18</sup>F-fluciclovine PET-CT was significantly higher versus standard-of-care imaging on the patient and combined region levels, while there were no significant differences between <sup>68</sup>Ga-PSMA-11 and standard-of care imaging. <sup>18</sup>F-fluciclovine cDR was also significantly higher than <sup>68</sup>Ga-PSMA-11 on the combined region level. Mean SUVmax for true positive metastatic and primary lesions with <sup>18</sup>F-fluciclovine (n = 18) was significantly greater than for <sup>68</sup>Ga-PSMA-11 (n = 11) [5.5 ± 1.8 versus 3.5 ± 2.7 respectively, p = 0.021].</p><p><strong>Conclusion: </strong>In this exploratory trial, <sup>18</sup>F-fluciclovine PET-CT has a significantly higher cDR for ILC metastases compared to standard-of-care imaging and to <sup>68</sup>Ga-PSMA-11. Mean SUVmax for true positive malignancy was significantly higher with <sup>18</sup>F-fluciclovine than for <sup>68</sup>Ga-PSMA-11. Exploratory data from this trial suggests that molecular imaging of amino acid metabolism in patients with ILC deserves further study.</p><p><strong>Clinical trial registration: </strong>Early phase (I-II) clinical trial (NCT04750473) funded by the National Institutes of Health (R21CA256280).</p>\",\"PeriodicalId\":11909,\"journal\":{\"name\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":8.6000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00259-024-06830-7\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-024-06830-7","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Prospective investigation of amino acid transport and PSMA-targeted positron emission tomography for metastatic lobular breast carcinoma.
Purpose: To explore the feasibility of imaging amino-acid transport and PSMA molecular pathways in the detection of metastatic breast invasive lobular carcinoma (ILC) and if there is superior detection compared to standard-of-care imaging [computed tomography (CT)/bone scan, or 18F-FDG positron-emission-tomography (PET)-CT].
Methods: 20 women with de-novo or suspected metastatic ILC underwent two PET-CT scans with 18F-fluciclovine and 68Ga-PSMA-11 on separate days. Uptake per patient and in 3 regions per patient - ipsilateral axillary lymph node (LN), extra-axillary LN (ipsilateral supraclavicular or internal mammary), or distant sites of disease - was compared to standard-of-care imaging (CT/bone scan in 13 patients and 18F-FDG PET-CT in 7 patients). Results were correlated to a composite standard of truth. Confirmed detection rate (cDR) was compared using McNemar's test. Mean SUVmax of 18F-fluciclovine and 68Ga-PSMA-11 in the most avid lesion for each true positive metastatic region and intact primary lesion were compared by t-test.
Results: The cDR for standard-of-care imaging was 5/20 patients in 5/60 regions. 68Ga-PSMA-11 PET-CT detected metastasis in 7/20 patients in 7/60 regions. 18F-fluciclovine PET-CT detected metastasis in 9/20 patients in 12/60 regions. The cDR for 18F-fluciclovine PET-CT was significantly higher versus standard-of-care imaging on the patient and combined region levels, while there were no significant differences between 68Ga-PSMA-11 and standard-of care imaging. 18F-fluciclovine cDR was also significantly higher than 68Ga-PSMA-11 on the combined region level. Mean SUVmax for true positive metastatic and primary lesions with 18F-fluciclovine (n = 18) was significantly greater than for 68Ga-PSMA-11 (n = 11) [5.5 ± 1.8 versus 3.5 ± 2.7 respectively, p = 0.021].
Conclusion: In this exploratory trial, 18F-fluciclovine PET-CT has a significantly higher cDR for ILC metastases compared to standard-of-care imaging and to 68Ga-PSMA-11. Mean SUVmax for true positive malignancy was significantly higher with 18F-fluciclovine than for 68Ga-PSMA-11. Exploratory data from this trial suggests that molecular imaging of amino acid metabolism in patients with ILC deserves further study.
Clinical trial registration: Early phase (I-II) clinical trial (NCT04750473) funded by the National Institutes of Health (R21CA256280).
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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